Discussions By Condition: I cannot get a diagnosis.

Uncharacteristic sexual...problems (?)

Asking about this has always seemed odd to me, but I'm sort of worried at this point, so I need to ask. I'm a teenage male. I don't drink, I don't smoke. My girlfriend is a bit of a distance away at the moment, but we each still have a webcam. I'd rather not go into detail, but I think you can see where this is going. Before everything was great, no problems at all. But lately, I don't know. I still get aroused, but after we're go for a while I start to lose it, I still finish, but then it's sore afterwards, and it's a bit of struggle getting there again. Do I just need to lube up? Like, it's not that I'm not aroused, because I do find her attractive, but it's like I have a problem keeping it there lately, which I'm preeeetty sure is uncharacteristic for my age. I also don't think it's that I just need to take a break, because we only really do it on weekends.

5 Replies:

Departure from the normal "characteristics" of sexual interaction constitutes a form of novelty. In the absence of direct contact, this type of novelty can demonstrate a certain appeal that translates to increased libido or excitation. The novelty, however, tends to wear off because the emphasis is more psychological than physical when attempting to practice sexual interaction from a distance. Under the circumstances, you will likely find it necessary to vary the means of interaction in order to retain full sexual interest. Care must be taken, however, to avoid the creation of a paraphilia which can arise in instances where traditional sexual interaction is predominated by an abstract representation rather than in the conventional sense. An example here would be the intentional efforts to produce variations in internet sexual behavior and fulfillment to such an extent that sexual arousal cannot subsequently be gained in the absence of an internet environment. It's important to realize that sexual arousal is 99% psychological and therefore, caution should be exercised to avoid increasingly abstract fantasy necessary to achieve fulfillment such that it dampens traditional direct sexual contact. Do you understand what I mean here? In other words, as you practice internet interaction, you may find it increasingly necessary to use more heightened fantasy stimulation to achieve the same end result and people sometimes find themselves conjuring up some rather creative scenarios in order to produce the desired climax. Over time, the result can produce unwanted results in the way of subsequently viewing traditional sexual interaction as non-stimulating enough. It matters less that you only practice this on "weekends" but more importantly whether it constitutes your only means of sexual arousal with your partner. Regardless of whether it's once a week or several, if it represents the only method of sexual arousal, you must be careful not to let it create blunting of traditional sexual relations. Otherwise, you might find yourself with erectile difficulty under more traditional scenarios if the internet method forms a sort of imprintation. The other issue to realize here is that this sort of arrangement can sometimes produce doubts or questions about both self-confidence and infidelity, with unwanted thoughts about whether your partner is satisified with the internet arrangements or whether she may be courting your efforts but is nevertheless exposed to the prospects of direct sexual interest and contact with someone that could be more preferable. In other words, doubt about whether she is satisified with the present arrangement can place a severe damper on your ability to perform and achieve sexual climax, resulting in frustration. The substitution of direct sexual contact raises questions about its ability to retain one's partner from being drawn away to more conventional means. Best regards, J Cottle, MD

Thanks, and you're right, paraphilia is something I have started to worry about. But as far as a solution, where do I go from here? I think it's understandable that I'm not sure how to tell her about this, but what should we do, exactly? It's going to be a very long time before we can be together, and the last thing I want is for one of us to get bored. Should we stop altogether? Decrease the frequency? Or just do it without it necessarily being to each other? I want to make this last, and this is starting to worry me, so any advice would be greatly appreciated.

Well, while there are no steadfast rules about your dilemma, a commmon sense approach is usually the most accurate. While affection can be experienced from afar, sexual intimacy in the genuine sense very naturally requires direct contact. To try and create an artificial environment in the hopes of somehow accomplishing that type of intimacy does no justice to what you previously shared with this person. I certainly won't advise you whether to curtail the activity or even whether I think it's appropriate. Being distant from someone you care a great deal about can be a difficult challenge and cause for reflection. I can tell you that certain aspects of intimacy, whether sexual or otherwise, cannot be experienced in an artificial medium with the hopes of producing or maintaining the same outcome as with direct contact. The manner and regard we hold for such practices is derived from the very basis of our character. It is the respect we garner for the most intimate experiences that makes them so special. Thus, it is better to hold a memory in highest regard than to sacrifice it for any lesser experience. You seem like a bright young fellow. I'm sure you'll draw the right conclusion and make a decision in the best interests of everyone involved. Best regards, J Cottle, MD

I think the irony right after you called me a "bright young fellow" is that I didn't quite express my question the right way. I wasn't quite asking for emotional/moral/personal guidance, because obviously that's something I need to decide. I mean, obviously I understand that I need to talk to her, but on a purely physiological scale, what the possible negative repercussions of this? I know continuing on can't be healthy, but if I'm going to solve this, I'd like to know all the sides, you know? I know I'm a bit naive here, so thanks in advance for the patience.

Okay, well I've previously explained the potential psychological ramifications of the practices alluded to and the only physical repercussion in such instances would be mild abrasions to the penile tissues and muscle fatigue. The assertions regarding my constitutional remarks were entirely my own, but under the circumstances were worth mentioning simply because one's successful resolve from such a perspective would entirely preclude the need to question any subsequent physical or psychological ramifications. Best regards, J Cottle, MD